二维斑点追踪技术评价完全性左束支传导阻滞对左心室扭转的影响  

Evaluation of the Effect of Left Ventricular Twist in Patients with Complete Left Bundle Branch Block Using Two-dimensional Speckle Tracking Echocardiography

作　　者：陈孟嘉 李东东[1] 李光源[1] 马春燕[1] Chen Mengjia;Li Dongdong;Li Guangyuan;Ma Chunyan(Department of Cardiovascular Ultrasound,The First Hospital of China Medical University,Shenyang 110001,China)

机构地区：[1]中国医科大学附属第一医院心血管超声科,沈阳市110001

出　　处：《中国超声医学杂志》2023年第6期665-668,共4页Chinese Journal of Ultrasound in Medicine

基　　金：国家自然科学基金联合基金(No.U21A20387);沈阳市科学技术计划(No.20-205-4-014)。

摘　　要：目的 采用斑点追踪技术评价左心室射血分数(LVEF)正常的完全性左束支传导阻滞(CLBBB)患者的左心室扭转特征。方法 选择射血分数正常的CLBBB患者43例作为病例组,健康受试者32例作为对照组。按照QRS时限将病例组分为窄QRS组(120 ms≤QRS≤150 ms)及宽QRS组(QRS>150 ms)。应用斑点追踪技术测量左心室扭转功能参数[心尖、基底旋转角度峰值(PAR、PBR)、扭转角度峰值(Ptw)和扭转速度峰值(Ptv)]及左心室解旋功能参数[等容舒张期解旋比例(Untw)、解旋率(Untw-R)和解旋速度峰值(Puv)]。结果 与对照组相比,病例组Ptw、PAR、PBR、Untw和Untw-R显著减低;与窄QRS组比较,宽QRS组Ptw减低(P<0.05)。相关性分析显示CLBBB患者Ptw与QRS时限呈负相关(r=-0.386,P=0.012);PAR与LV-GLS呈正相关(r=0.342,P=0.035);PBR与Untw和Untw-R呈正相关(r=0.349,P=0.027;r=0.406,P=0.009),与E/e′呈负相关(r=-0.347,P=0.026)。结论 LVEF正常的CLBBB患者左心室扭转及解旋功能减低,QRS时限影响左心室扭转,宽QRS患者左心室扭转减低更显著。左心室心尖扭转角度与收缩功能有关,而基底扭转角度与舒张功能有关。Objective To evaluate the effect of complete left bundle branch block(CLBBB)in patients with normal left ventricular ejection fraction(LVEF)on left ventricular twist by speckle tracking imaging.Methods 43 CLBBB patients with normal LVEF were selected as the case group,and 32 healthy people were selected as the control group.According to QRS duration,the patients were into narrow QRS group(120 ms≤QRS≤150 ms)and wide QRS group(QRS>150 ms).Speckle tracking imaging were uesd to measure left ventricular twist function parameters including peak twist(Ptw),peak apical rotation(PAR),peak basal rotation(PBR),peak twist velocity(Ptv),and untwist function parameters including untwisting during isovolumetric relaxation(Untw),untwisting rate(Untw-R),and peak untwist velocity(Puv).Results Compared with the control group,Ptw,PAR,PBR Untw and Untw-R in the case group were significantly decreased.Compared with the narrow QRS group,Ptw in the wide QRS group decreased(P<O.05).Correlation analysis showed a negative correlation between Ptw and QRS duration in CLBBB patients(r=-0.386,P=0.012).PAR was positively correlated with LV-GLS(r=0.342,P=0.035).PBR in CLBBB patients was positively correlated with Untw and Untw-R(r=0.349,P=0.027 and r=0.406,P=0.009),and negatively correlated with E/e'(r=-0.347,P=0.026).Conclusions Left ventricular twist and untwist decreases in CLBBB patients with normal LVEF.QRS duration affects left ventricular twist in CLBBB patients,and the left ventricular twist significantly decreased in the patients with wide QRS.Left ventricular apical twist is related to the systolic function,and the base twist is related to the diastolic function.

关 键 词：左心室扭转 完全性左束支传导阻滞 斑点追踪技术 

分 类 号：R54[医药卫生—心血管疾病]